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Query: UMLS:C0040425 (tonsillitis)
 1,594 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Infection with influenza A (H5N1) virus, which has not been associated with respiratory disease in humans previously, caused clinical signs of acute respiratory distress syndrome and multiple-organ dysfunction syndrome with high mortality in humans in Hong Kong in 1997. To study the pathogenesis of this disease, we infected four cynomolgus monkeys (Macaca fascicularis) with 2.5 x 104 median tissue culture infectious dose (TCID50) of influenza virus A/Hong Kong/156/97 (H5N1) and euthanatized them 4 or 7 days after infection. The main lesion was a necrotizing broncho-interstitial pneumonia (4/4) similar to those found in primary influenza virus pneumonia in humans, with desquamation of respiratory epithelium (4/4), intra-alveolar hemorrhage (4/4), hyaline membrane formation (2/4), and infiltration with neutrophils and macrophages (4/4). Lesions in other organs consisted of a suppurative tonsillitis (2/4) and necrosis in lymphoid organs (1/4), kidney (1/4), and liver (1/4). By immunohistochemistry, influenza virus antigen was limited to pulmonary tissue (4/4) and tonsils (2/4). Based on these results, we suggest that the cynomolgus monkey is a suitable animal model for studying the pathogenesis of human H5N1 virus infection and that multiple-organ dysfunction syndrome in this disease may be caused by diffuse alveolar damage from virus replication in the lungs alone.
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PMID:Pathology of human influenza A (H5N1) virus infection in cynomolgus macaques (Macaca fascicularis). 1272 72

Oral gonococcal infection is an uncommon but well-described manifestation of gonococcal infection, usually described as pharyngitis in the literature. Tonsillitis is much rarer and its role in the clinical presentation in oral gonorrhea is less clear. We describe a case of oral gonorrhea presenting with tonsillitis and a discrete cervical lymphadenopathy and present a review of the literature from 1961 to 2002. Of the 512 reported cases of oral gonococcal infection, only 61 have been described to be tonsillitis. The tonsils were invariably enlarged and infected. A whitish-yellow exudate in the cryptae was described in 12 cases (20.6%). Fever and cervical lymphadenopathy appear to be rather uncommon, since they have been described in only five (8.2%) and six (9.3%) of the 61 patients with tonsillitis, respectively. Gonococcal tonsillitis should be included in the differential diagnosis of tonsillitis in sexually active patients.
Infection 2003 Oct
PMID:Gonococcal tonsillar infection--a case report and literature review. 1455 65

The global epidemic of HIV infection remains appalling. By 2001, there were an estimated 1.4 million HIV-infected children, with 4.5 million deaths. In the UK, paediatric cases are clustered around population centres where there are high concentrations of infected immigrant adults, and to a lesser extent, areas where IV drug abuse is common. The highest incidence remains in London and the southeast. With the national redistribution of immigrant and refugee families, any doctor in any specialty may expect to be involved with children who are HIV positive, or have clinical AIDS. The majority of children are infected vertically, i.e. infection of the infant from an infected mother in the pre-, peri-, or post-natal periods. Rates of transmission vary from 15-20% in the developed countries. Children with HIV infection may have their primary presentation to ENT doctors, who should have appropriate thresholds for suspecting the diagnosis. The most common presenting features include persistent generalised lymphadenopathy, hepatosplenomegaly, chronic/recurrent diarrhoea, poor growth, and fever. Fifteen to twenty percent of untreated children will present with an AIDS-defining illness by 12 months, typically with Pneumocystis pneumonia at approximately 3-4 months of age. Seventy percent of perinatally infected children will exhibit some signs or symptoms by 12 months Without treatment, the median age to progression to AIDS is approximately 6 years, and 25-30% will have died by this age. The median age of death is approximately 9 years. Children may also present with repeated/unusual ear infections, sinus disease (inc. mastoiditis), tonsillitis, orbital/peri-orbital cellulitis, oral candidiasis, and dental infections. Infections with streptococcus pneumoniae and group A streptococcus are common, and often progress to severe systemic infection with an appreciable mortality. Infections may be due to unusual pathogens such as Pseudomonas, 'typical' and atypical Mycobacteria, Candida, Aspergillus, etc. Fungal infections of the sinuses (inc. Aspergillus and Rhizopus spp.) may be particularly devastating, with rapid spread to involve bone and the central nervous system. Another classical presentation, which may present to ENT doctors, is that of bilateral parotid enlargement, especially in children who are 'slow progressors', many of whom also have Lymphoid Interstitial Pneumonitis (LIP). A major attitudinal change has occurred due to advances in 3 main areas: (i) the multidisciplinary management of the infected mother (inc. counselling, antenatal screening, elective caesarean section, advising against breast feeding, etc.), (ii) the prevention of vertical transmission, using anti-retroviral therapy to the infected mother during pregnancy, and to the potentially infected infant in the first weeks of life, and (iii) major advances due to the advent of highly active anti-retroviral treatment. With effective use of these measures, transmission rates may be reduced to <2%. None of the measures though, affect a cure, and it will still be many years before the development of effective vaccines. ENT doctors may be referred children already known to be HIV-positive. Knowing how to talk to infected children (and their parents) is full of potential pitfalls, and requires careful forethought. Many infection-control policies have required considerable rethinking due to the AIDS epidemic. This has especially been the case with respect to needle-stick injuries, post-exposure prophylaxis, sterilization and re-use of equipment, and safe approaches to surgery.
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PMID:HIV infection in children--impact upon ENT doctors. 1466 74

The global spread of antibacterial resistance has important implications for the current and future management of bacterial respiratory tract infections in children. Data suggest that emerging resistance to commonly prescribed antibacterials, such as macrolides and trimethoprim-sulfamethoxazole, is beginning to impact the treatment of these infections, which include acute otitis media, tonsillitis/pharyngitis and community-acquired pneumonia. There is, therefore, a need for additional agents that are active against common respiratory tract pathogens, including resistant strains and are suitable for use in children. Infection control measures to curb the clonal spread of antibacterial resistance are also extremely important.
Infection 2004 Apr
PMID:Therapeutic implications of antibacterial resistance in community-acquired respiratory tract infections in children. 1505 74

A rare case of primary peritonitis caused by group A beta-hemolytic streptococcus in previously healthy woman is presented. The entry site of infection was tonsillitis. Infection was complicated by soft-tissue infection of abdominal and thoracic wall, associated with toxic shock. Streptococcus growth was obtained in the cultures from the tonsils and blood. The patient underwent surgery: laparoscopy, laparotomy and multiple incisions in the phlegmon site. The lasting administration of penicillin caused recovery.
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PMID:[Primary peritonitis caused by group A beta-hemolytic streptococcus]. 1551 20

Mitochondrial diseases are primary defects in bio-energy metabolism. They are a heterogeneous group of diseases. The specific constellation of symptoms that will manifest in the effected individual depends on the type of genetic defect in the mitochondria. The goals of medical management, expressed in a highly simplified fashion, are to maintain a normal acid-base balance and to avoid those medical conditions and situations that add extra stress to a compromised bio-energy production system. Infection is a common stress that may cause a crisis in a patient with mitochondrial dysfunction. Treatment and avoidance of infections is a goal of both medical and surgical management. Common childhood illness such as otitis media, tonsillitis and sinusitis are example of such stress inducing infections.
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PMID:Surgical and anesthetic management of patients with mitochondrial dysfunction. 1612 Apr 12

Acute tonsillitis is a common condition and usually runs a benign course. However life-threatening complications do still occur, even in this postantibiotic era. Infection can spread downwards into the mediastinum through the anatomic cervical spaces, causing widespread cellulitis, necrosis, abscess formation and sepsis. We present a case of descending mediastinitis in an 18-year-old woman, arising from her first episode of tonsillitis and treated successfully by surgical drainage. We believe that an awareness of this complication, early diagnosis using computed tomography scanning, and prompt, adequate surgical drainage will reduce morbidity and mortality.
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PMID:Mediastinitis: a life-threatening complication of acute tonsillitis. 1615 22

Streptococcus pyogenes is a major causative agent of tonsillitis or pharyngitis in children. Streptococcus pyogenes can persist in tonsils, and one-third of children treated with antibiotics continue to shed streptococci and have recurrent infections. Mouse nasal-associated lymphoid tissue (NALT) is functionally analogous to human oropharyngeal lymphoid tissues, and serves as a model for characterization of the mucosal innate immune response to S. pyogenes. Wild-type S. pyogenes induces transcription of both type I and interferon-gamma (IFN-gamma)-responsive genes, proinflammatory genes and acute-phase response proteins 24 h after intranasal infection. Invasion of NALT and the induction of the interferon response were not dependent on expression of antiphagocytic M protein. Intranasal infection induces a substantial influx of neutrophils into NALT at 24 h, which declines by 48 h after infection. Infection of IFN-gamma(-/-) [IFN-gamma knock-out mouse (GKO)] C57BL/6 mice with wild-type S. pyogenes resulted in local dissemination of bacteria to draining lymph nodes (LN), but did not lead to systemic infection by 48 h after infection. Infected GKO mice had an increased influx of neutrophils into NALT compared with immunocompetent mice. Thus, IFN-gamma-induced responses are required to prevent local dissemination of streptococci to the draining LN.
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PMID:The early interferon response of nasal-associated lymphoid tissue to Streptococcus pyogenes infection. 1924 34

Over 80 per cent. of school sickness, whether judged by the number of cases or by the time lost, is transmitted by "droplet" infection.The alleged increase in sickness in public schools is partly apparent, due to increased attention to minor febricula and partly real, due (1) to increased influenza prevalence, the aftermath of the great epidemic of 1918, and (2) to the increased demand for public school education leading to pressure upon accommodation, and especially to overcrowding in dormitories.The bulk of the droplet infections are accounted for by (1) influenza; (2) feverish cold, chill, or P.U.O.; (3) tonsillitis; regular infectious diseases make a comparatively small showing. The incidence and bacteriological findings and the variations in the incidence of pneumonia and otitis media are discussed. Are these complications really secondary epidemics? Tonsillitis, bacteriological findings, milk.Prophylaxis.-Efficacy of vaccines uncertain. Some evidence that they may diminish the onset of complications. If given vaccines should be administered before the danger period, i.e., not later than November.Intensive prophylaxia other than vaccines during the first half of the Lent term would probably amply repay any trouble. It should include:-(a) Special efforts to prevent boys returning to school after the Christmas holidays infected with influenza or febricula.(b) Temperature taking for three weeks.(c) Immediate isolation of all pyrexias and catarrhs.(d) No work before breakfast for at least the first six weeks of the term.(e) All hot baths and showers taken during the day or after games to be followed by cold showers.(f) Prevention of chill in watching games, etc.(g) Increased provision for drying clothes, uniforms and boots.Infection mainly takes place in sleeping quarters, and proper spacing out of beds and thorough "cross" ventilation in dormitories is of paramount importance; instances of cross infection due to proximity of beds; illustrated by bed charts and bacteriological findings; standards of wall space, floor space and cubic space, laid down by the Royal Commission, Board of Education.No school authority has done its duty to its pupils unless it has provided dormitory accommodation allowing at least 3 ft. of clear space between the edges of beds, and thorough and through ventilation. Until these essential wants are met, the provision of properly sited, amply spaced and "cross" ventilated dormitories should take precedence of all other building requirements.Milk should be pasteurized.
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PMID:Some Observations on Naso-pharyngeal Epidemics in Public Schools. 1998 81

Infections are considered one of the most common causes of morbidity and mortality in patients with systemic lupus erythematosus (SLE), and occasionally can trigger a catastrophic antiphospholipid syndrome (APS). We describe a 22-year-old SLE patient with lupus nephritis under immunosuppressant therapy and asymptomatic carrier of antiphospholipid antibodies, who was admitted with tonsillitis and acute hepatitis, developing multiorgan failure in a few hours. Postmortem examination revealed hepatic necrosis, tonsillitis, pharyngitis and uterine cervicitis caused by herpes simplex virus (HSV) together with microthrombosis in lungs and glomerular arterioles, suggesting the diagnosis of fulminant HSV disseminated infection and catastrophic APS.
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PMID:Catastrophic antiphospholipid syndrome triggered by fulminant disseminated herpes simplex infection in a patient with systemic lupus erythematosus. 2293 Feb 5


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